1Enas El-Zamarany, 2Mai Salama, 2Magdy El-Masry and 2Abdel Megeed El Ballat.
Departments of 1Clinical Pathology and 2Cardiology, Tanta University, Tanta, Egypt.
Autoimmunity has been proposed as a major participant in the pathogenesis of human dilated cardiomyopathy on the basis of observed abnormalities involving both cellular and humoral immunity. Both serum neopterin and soluble interleukin-2 Receptor. (sIL-2R) levels reflect activation of T-lymphocytes in the periphery or tissues. The aim of the present work is to study the possibility of activation of cellular immunity in patients with dilated cardiomyopathy and fined out its correlation with disease severity and functional consequences. The study was carried out on 30 patients with idiopathic dilated cardiomyopathy, 30 patients with ischemic heart disease and 20 normal control subjects. Serum neopterin level was estimated by radioimmuno assay (RIA) technique while sIL-2R was estimated by an enzyme-linked immunosorbent assay. High serum neopterin (> 5.5 ng/ml) was found in 53.3% of patients with dilated cardiomyopathy verus 6.6% of patients with ischemic heart disease. High levels of sIL-2R (> 78 Pm/L) were reported in 46.6% of the dilated cardiomyopathy patients versus 3.3% of the ischemic heart disease patients. Positive patients for both neopterin and sIL-2R were characterized by more severe disease as judged by higher New York Heart Association (NYHA) functional class, lower ejection fraction and higher left ventricular filling pressure. It is concluded that T- lymphocyte activation as reflected by elevated serum neopterin and sIL-2R levels is frequently encountered in patients with dilated cardiomyopathy and is associated with advanced severity of the disease.